Support for articles and methods for using the same

ABSTRACT

A support for an article has a body arranged for length adjustment along a length adjustment axis. A tensioning device is connected to the support and adjustment of the tensioning device shortens or lengthens a length of the support along the length adjustment axis. The body defines at least one opening overlapping at least part of the length adjustment axis such that length adjustment is governed by modification of the size of the at least one opening according to adjustment by the tensioning device.

FIELD OF THE DISCLOSURE

The disclosure relates to a support for articles and methods for usingthe same. In a preferred embodiment, a support is arranged to provideincremental stabilization and compression to a patella and may be usedalone or in combination with an orthopedic device.

BACKGROUND

Supports and straps are used in various articles for supporting,placement or closure about a body part. Straps are conventionally usedfor being tensioned or used to increase the fit or comfort of thearticle. The straps may be combined with supports for stabilizing orcompressing against a body part. Often, however, supports are staticallyattached to an article and straps are separately positioned or spacedfrom the article.

While supports and straps may be used in different articles, they arepredominately found in orthopedic devices. In an example, there arenumerous orthopedic devices such as braces that provide support around apatella of a user. Many of these braces use a stationary or staticsupport that provides support about the patella of the user.

Some of the known braces include a front central opening that allow forthe wearer's patella or kneecap to project therethrough. The frontcentral opening relieves pressure otherwise exerted on the patella,particularly when the knee is bent or in flexion. These braces mayinclude a pad or support located about the front central opening toprovide a restraining force to the patella and additional support forpreventing lateral or medial displacement of the patella in the femoralgroove.

Despite known solutions, many braces fail to maintain the support in aproper position on the patella so the opening or support can preventpatella displacement, in part due to their static arrangement; they arenot arranged to accommodate movement or flexion of the knee.

Alternatively, another example of a brace has a strap and a patellasupport attached to the strap for applying patellar support. One end ofthe strap has the patella support fixed near the patella of a user and asecond end secures to a connection point along a lateral or medial sideof the brace. As the strap is tensioned, the support applies pressureabout the patella. The support itself, however, does not change in shapeaccording to exertion of tension in the straps; rather they are merelycompressed against the knee.

Many known devices fail to maintain the support in a proper position onthe patella so the opening or support can prevent patella displacement.Therefore, there is a need for a knee brace that at least provides meansfor stabilizing and supporting the patella.

A large group of people suffer from patellofemoral osteoarthritis (OA);either stand-alone patellofemoral OA or, in combination with medial orlateral side OA. There are few if any commercial patellofemoral OAsolutions on the market.

A purpose of a patellofemoral OA brace is to relieve knee pain caused byOA in the patellofemoral joint. An unloading type knee brace provides asolution for people with medial or lateral side knee OA, such as onedescribed in U.S. Pat. No. 7,198,610, granted Apr. 3, 2007, andincorporated herein by reference. There exists no solution that targetsindividuals suffering from stand-alone patellofemoral pain and incombination with medial side OA.

SUMMARY

The combination of the patellofemoral (PF) joint and OA is a significantproblem for the patient as is OA in the tibiofemoral (TF) joint. Thesolutions described herein are aimed for the sufferer of combined TF/PFOA, as the pain may originate from either or both joints. For thecombined TF/PF condition, treating the TF joint alone may not besufficient. Solutions are also described to treating isolated PF OA orPF instability or deficiencies.

Various solutions relied upon to treat PF OA may employ a compressivesleeve with inelastic or elastic parts, a compressive padding and/orvarious strap arrangements. Particularly, the compressive padding mayinclude an arcuate pad or strap system with and without variabletensioning, such as in dial tensioning.

In one variation, the solution relies on moving the patella medially andsecuring it in position by a variety of techniques. Patellar maltrackingusually means that the patella is positioned too far on the lateralside. Because of PF problems, the patella is almost always pulledmedially.

Embodiments of the patella device are adjustable, reliable and durable,and may mimic various taping techniques. Realignment of the patellaplaces it more properly in the trochlea groove. In the aligned position,the PF joint's articulation surface is increased and the increasedsurface of articulation means the joint loads are more evenlydistributed and high local forces are prevented.

A pad or support may be used or added to the support to contribute tothe sideway force. The support creates extra surface area and holds aside of the patella, either alone or in combination with a strap, tofocus and direct the force. The support is preferably adjustable andallows adjustment of the direction of the force providing the user theopportunity to adjust the direction of the applied force according tothe user's condition. The point of friction in the patellofemoral jointcan vary between persons and the support can be positioned around thearea of the pain.

In an embodiment, a strap may be attached to a support that sits on topof the sleeve. By attaching the strap to the support, a stable anchoringpoint is created. There may be a benefit in attaching the strap to themedial side of the sleeve or attaching it to the lateral side of thesleeve and placing the attachment point on the medial side. Attachingthe strap to the sleeve may improve comfort and enables the user to usethe sleeve independent of an unloader brace.

Embodiments may employ a C-shaped strap or support, and may include atensioning device that adjusts the C-strap or support. This embodimentrests on the concept of adjustably unloading the patella by tensioningwhich pushes the knee into the hinge creating an unloading force.

Variations may be arranged to increase forces on the patella as the kneeflexes such that as the knee flexes, the force on the patella increasesmedially. The variations may be adjustable with a dial tensioning systemwhereby the support includes at least one adjustable anchor point. Thisarrangement provides the user the possibility to position the support asneeded and apply a suitable amount of force.

In an embodiment, the patella device includes a sleeve defining firstand second sides divided by a medial-lateral plane, and a centralportion defined along an anterior side of an anterior-posterior plane. Asupport has a body defining a first end anchored to the first side ofthe sleeve and a middle portion anchored to the second side of thesleeve. The support is located proximate the central portion which maydefine an opening. The support may define at least one opening formedalong the length of the support and extends from a periphery into awidth of the support. The at least one opening may be defined by a firstset of openings formed along a first periphery and a second set ofopenings is formed along a second periphery. The first and secondopenings alternate relative to one another along a length of thesupport.

A tensioning device is coupled to the support and adjusts the length ofthe support by opening or compressing the openings. The support mayoperate in the manner of an accordion by the openings to conform to theuser's anatomy and facilitate force generation over the patella. Thetensioning enables selective tensioning of the support.

According to an embodiment, the body defines a length adjustment axis,which may be located generally along a midline of the body. The lengthadjustment axis depends upon the contour of the body such that the bodymay bend and the length adjustment axis follows the bend. At least oneof the openings overlaps at least part of the length adjustment axissuch that length adjustment is governed by modification of the size ofthe at least one opening according to adjustment by the tensioningdevice.

In an embodiment, the body defines at least one opening overlapping atleast part of the length adjustment axis such that length adjustment isgoverned by modification of the size of the at least one openingaccording to adjustment by the tensioning device. The at least oneopening may be formed along the length of the support and extend from aperiphery into a width of the support. The at least one opening extendspast the length adjustment axis of the support from the periphery.

According to an example, the at least one opening may define first andsecond ends with the first end extending past the length adjustment axisshort of a first periphery and the second end defined by opposed sideportions arranged to clamp against one another depending on the lengthof the support. The first and second openings alternating relative toone another along a length of the support.

At least one cable may be linked to the tensioning device and cooperateswith the support to adjust the length thereof by actuation of thetensioning device. The at least one cable may extend through a thicknessof the body of the support from the first portion to the second portionsuch that actuation of the tensioning device adjusts the length of theat least one cable to adjust the length of the support. The at least onecable may intersect or pass through one of the openings in the body ofthe support.

According to a variation, the at least one cable includes first andsecond cable segments linked to the tensioning device and extending tothe first and second portions, respectively. The first and second cablesegments are individually attached to the tensioning device and operatedindependently from one another by each having an end opposite from aportion engaging the tensioning device. The first and second cablesegments may form a loop with the tensioning device and are regulatedsimultaneously and dependently with one another.

The support may be arranged in a variety of geometries, whether shapeprofile, height, width, thickness or length. The opening can be modifiedlikewise according intended usage of the support.

A method for adjusting a length of the support includes adjustingtension in the at least one cable by regulating the tensioning deviceand causing geometry of the at least one opening to modify according totension in the cable. Depending on usage and application of the support,additional steps may include anchoring first and second ends of thesupport to first and second locations, the length of the supportadjusting along the length adjustment axis according to regulation ofthe tensioning device; providing at least one peripheral opening along aperiphery of the support; and contouring a shape of the supportaccording to regulation of the tensioning device by modifying a geometryof the peripheral opening as a result in adjustment of tension in the atleast one cable.

According to an embodiment in the form of an orthopedic device, thesupport tracks the patella and provides support. The support and strapsassociated with the sleeve creates a medial/lateral force that tracksthe patella in a desired direction (lateral or medial). The support maybe used along or in combination with an OA brace.

The support provides dynamic tracking of the patella by its ability toadapt in shape as the support is tensioned. The support combinesfunction of both a strap and a support because the support itself istensioned and adapted to adjust in geometry according to the tensioningof the support. The support may have compressible features, such as abody forming part of the support as constructed from a porous orcompressible material such as foam.

The support may be adapted as a strap in part due to its ability toresize according to tension in the support. An advantage of the strap isthat it may cover greater surface area to better distribute tension overthe object by which it is secured, as in a body part. In another use,the support may be arranged to provide increased or decreased rigiditybecause of tensioning the support, in part by adjusting rigidity of asupport body or geometry of the support body.

The support is not limited to use in a PF support, but may be used inarticles and applications requiring stabilization, closure, compression,rigidity and other expedients.

DESCRIPTION OF THE DRAWINGS

The support is described referring to the accompanying drawings, whichshow preferred embodiments according to the device described. The deviceand method as disclosed in the accompanying drawings are illustrated forexample only. The elements and combinations of elements described belowand illustrated in the drawings can be arranged and organizeddifferently to result in embodiments still within the spirit and scopeof the device described.

FIG. 1 is a perspective view of one side of a patella device.

FIG. 2 is a perspective view of another side of the patella device ofFIG. 1.

FIG. 3A is a plan view of an embodiment of a support in the patelladevice of FIG. 1.

FIG. 3B is a cross-section taken along lines 3B-3B in FIG. 3A.

FIG. 4 is a detail view of attachment of a middle portion of the supportof FIG. 1 to a sleeve.

FIG. 5 is a detail view showing an end portion of a support.

FIGS. 6A-6E are schematic views showing alternative openings in asupport or strap.

FIG. 6F is a schematic view showing a variation of a support or strap.

FIG. 6G is a schematic view showing another variation of a support orstrap.

FIG. 7A is a schematic view showing a cable system in the support ofFIG. 1.

FIG. 7B is a schematic view showing another cable system.

FIG. 7C is a schematic view showing another cable system.

FIG. 8 is a plan view of another embodiment of a support for the patelladevice of FIG. 1.

FIG. 9 is a plan view of another embodiment of a support for the patelladevice of FIG. 1.

FIG. 10 is a plan view of another embodiment of a support for thepatella device of FIG. 1.

FIG. 11 is a perspective view of the patella device in combination withan orthopedic device.

FIG. 12 is a perspective front view of another embodiment of a patelladevice.

FIG. 13 is a perspective side view of the patella device of FIG. 12.

FIG. 14 is a perspective view of another embodiment of a patella device.

FIG. 15 is a perspective front view of the patella device of FIG. 14 inan orthopedic device.

FIG. 16 is a perspective rear view of the patella device of FIG. 15 inthe orthopedic device of FIG. 14.

FIG. 17 is a perspective view of an ankle brace having a support.

FIG. 18 is a front view of an ankle brace of FIG. 17.

FIG. 19 is a side view of an ankle brace of FIG. 17.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS

A better understanding of different embodiments of the support may begained from the following description read with the accompanyingdrawings in which like reference characters refer to like elements.

While the disclosure is susceptible to various modifications andalternative constructions, certain illustrative embodiments are in thedrawings and will be described below. It should be understood, however,there is no intention to limit the disclosure to the embodimentsdisclosed, but on the contrary, the invention covers all modifications,alternative constructions, combinations, and equivalents falling withinthe spirit and scope of the disclosure and defined by the appendedclaims.

It will be understood that, unless a term is defined in this disclosureto possess a described meaning, there is no intent to limit the meaningof such term, either expressly or indirectly, beyond its plain orordinary meaning.

Any element in a claim that does not explicitly state “means for”performing a specified function, or “step for” performing a function, isnot to be interpreted as a “means” or “step” clause as specified in 35U.S.C. § 112, paragraph 6.

B. Environment and Context of Embodiments

The supports and methods for use herein may be used in various articlesincluding braces, medical devices, clothing, apparel, bags, safetyrestraints and the like. In a preferred embodiment, the supports andmethods are described in connection with orthopedic devices.

Numerous orthopedic devices and components (e.g., subshells and strapretainers) for use therewith are described, with particular focus givento braces and components directed to the knee joint and surroundingareas. The orthopedic device embodiments may serve in protective,preventative or remedial capacities. While the orthopedic device isdescribed within the context of a preferred embodiment directed tosecuring the knee joint, many of the features described may be extendedto orthopedic devices and components that secure other joints and bodyparts, such as the wrist, elbow, shoulder, ankle and neck.

The orthopedic device embodiments and components for use therewith maybe dimensioned to accommodate different types, shapes and sizes of humanjoints and appendages. In addition, embodiments may be modified toorient principal forces exerted by support systems of the embodiments atany desirable location to secure the brace onto a leg to stabilize theknee.

The knee joint comprises two joints, lateral and medial, between thefemur and tibia, and one arthrodial joint between the patella and femur.The primary movements of the knee comprise flexion, i.e., rearwardrotational movement of the tibia relative to the femur, and extension,i.e., forward rotational movement of the tibia relative to the femur.

For explanatory purposes, each orthopedic device embodiment or componentthereof described may be divided into sections denoted by generalanatomical terms for the human body. Such anatomical terms are providedto distinguish various elements of the brace embodiments from oneanother, but which are not to be considered to limit the invention.

Each of these terms may be used regarding a human leg, which is dividedin similar sections with a proximal-distal plane generally extendingalong the meniscus of the knee between the femur and tibia. The terms“proximal” and “distal” generally refer to locations of the brace thatcorrespond to the location of leg relative to the point of attachment ofthe leg to the body. The terms “upper” and “lower” may be used incombination with “proximal” and “distal” to connote gradationsin-location of “proximal” and “distal.” The location where the bracecorresponds to the knee joint is used to generally delimit the proximaland distal sections of the brace.

The embodiments of the knee brace can also be considered to fall within“anterior” and “posterior” sections by an anterior-posterior plane. Theanterior-posterior plane generally corresponds to the coronal or frontalplane of a human leg, which lies along the central longitudinal axis ofa body. A posterior side or element is therefore behind thisanterior-posterior plane, whereas an anterior side or element is infront of the anterior-posterior plane.

The terms “inwardly” or “inner” are commonly used to distinguish theside of the brace that may be directed to the posterior side of thebrace and specifically adjacent to the leg of the wearer of the brace.Contrariwise, the term “outwardly” or “outer” are used to denote theside of the brace opposite to the inwardly side.

The terms “medial” and “lateral” are relative terms generally understoodas indicating location near the midsagittal plane or midline. Therefore,elements located near the midline are referred to as “medial” and thoseelements further from the midline are “lateral.” The term “central” isused to denote the area along the midline of a joint dividing andsharing regions of the medial and lateral regions.

In an embodiment of an orthopedic device, regions of the device may fallwithin the following quadrants: (I) proximal-medial, (II) distal-medial,(III) distal-lateral, and (IV) proximal-lateral. The posterior sectionof the brace has the following quadrants: (V) proximal-medial, (VI)distal-medial, (VII) distal-lateral, and (VIII) proximal-lateral.Structural members and features thereof will fall within one of thequadrants is specifically referenced in relation to such quadrant,either in its entirety or partially.

The terms “rigid” and “flexible” are repeatedly used to distinguishcharacteristics of portions of the brace. The term “rigid” should denotethat the frame is devoid of flexibility. Within the context of framemembers that are “rigid,” it should indicate that they might break ifbent with sufficient force. The term “flexible” should denote thatfeatures are capable of repeated bending. The term “resilient” is usedto qualify such flexible features as generally returning to theinitially molded shape with permanent deformation.

The anatomical and characteristic terms described herein are notintended to detract from the normal understanding of such terms asreadily understood by one of ordinary skill in the art of orthopedics.The elements of the embodiments described should embrace embodimentsthat generally correspond to the aforementioned anatomical sections. Itis understood that the elements of the brace embodiments described maydeviate from falling exactly within the confines of the aforementionedanatomical sections.

C. Various Embodiments

In observing the FIGS. 1 and 2, an embodiment of an orthopedic device isin a patella device 10 for treating a knee K and more particularly apatella Pa of the knee K. The patella device 10 comprises a sleeve 12defining first and second sides 13, 15 divided by a medial-lateralplane, and a central portion 23 defined along an anterior side “A” of ananterior-posterior plane. A support 14 in the form of a buttressincludes a main body 22 having a first end 17 anchored to the first side13 of the sleeve 12 and a middle portion 21 anchored to the second sideof the sleeve 12. The support 14 is located proximate the centralportion 23. The central portion 23 may define an opening 16 and thesupport 14 is arranged to extend across and over the opening 16.

The sleeve 12 is preferably short enabling it to be worn as astand-alone orthopedic device or in combination with a brace, asdepicted in FIG. 7. The sleeve 12 may be constructed from a firstsection of fabric, such as Lycra, in the anterior area or side, and suchfabric may be reinforced to provide rigidity yet is breathable. Theposterior area or side may be formed from a second section of fabric,such as Lyrca, that may be thinner or substantially thinner than thefirst section. The second section is preferably breathable, comfortablepermitting each donning and doffing, and a close anatomical fit. Thesurfaces of the first and second sections preferably have a low frictionsurface to permit movement of any straps from the orthopedic device.

The support 14 may define an arcuate shape or a C-shape, and is flexibleto conform to anatomy of a wearer of the orthopedic device 10. Thesupport 14 is preferably adjustable in length such that a first end 17of the support 14 includes first and second straps 34, 35 removablysecurable to a surface of the sleeve 12. The sleeve 12 defines afastener segment 38 arranged to secure to a corresponding connectionfeature carried by the first and second straps 34, 35.

The patella device 10 includes first and second flaps 36, 37 each havinga first end 39 secured to the sleeve 12 and a second end 41 flexiblyextending from the sleeve 12. The second ends 41 are arranged toadjustably secure to an outer surface of the sleeve 12 for adjusting acircumference of the sleeve. The sleeve 12 defines a fastener segment 38arranged to secure to a corresponding connection feature carried by thefirst and second straps 34, 35. The second end 41 of the first andsecond flaps 36, 37 secure to the fastener segment 38.

The flaps 36, 37 may be arranged to secure over and onto the first andsecond straps 34, 35 and the fastener segment 38. Adjustment of theflaps 36, 37 enable circumferential adjustment of the sleeve to assureit is retained on the leg of the user.

The support 14 may define first and second ends 17, 19 each extendingtoward the first side 13. The first and second ends 17, 19 have firstand second straps 34, 35 securable to the sleeve 12. The middle portion21 of the support 14 is arranged to resist adjustment of the first andsecond straps 34, 35. The main body 22 forming the support 14 ispreferably formed from a resilient compressible material, such as foam,textile, synthetic or natural rubber, polymer and the like. Theelasticity or inelasticity of the material forming the support willdepend on the application. In the patella device 10, the support 14 ispreferably inelastic to prevent the material of the support fromsignificantly yielding to movement of the user's knee.

The support may vary in width and thickness over its length orcross-section. For example, in FIG. 3A, the portion of the main body 22of the support 14 about a tensioning device 26 has a greater width W₁than a width W₂ at end portions of the support near the straps 34, 35.This arrangement is to at least accommodate the tensioning device 26 andprovide greater support at this section which hugs or embraces a side ofthe knee. Of course, the widths of the support may be modified for otherapplications whereby the widths are not limited to a couple of widthsbut the width may vary along the width according to intended use of thesupport and the anatomy or other about it extends.

Referring to the thickness, the thickness of the main body 22 may varyalong the length of the support 14 and over its cross-section. Forexample, FIG. 3B shows how the center portion 72 has a greater thicknessT₁ in part to provide greater rigidity and to accommodate channels 70through which cable segments 24, 25 extend, as discussed in greaterdetail below. The thickness T₂ at a periphery or edge portions 61, 63 isless than the center portion thickness T₁ to provide pressure reliefalong the periphery.

The main body 22 may be arranged so different surfaces may have varyingcontours according to desired areas of support and anatomy or other uponwhich the support extends. For example, FIG. 3B shows a rounded topsurface 74 with varying height as a result of the thickness of thesupport and pressure relieving properties of the periphery. A bottomsurface 76 is preferably flat so as secure fully or mostly against thesurface upon which the support extends.

Although exemplary widths, thicknesses and surface contours aredescribed, the support is not limited to the depicted examples, but mayinclude any combination and varying properties taking the examples inconsideration.

A stay 18 may be at one or both of the first and second sides 13, 15 andextending between first and second ends 31, 33 of sleeve 12. The stay 18is preferably within the sleeve 12.

According to an embodiment in FIG. 4, the connection assembly 20includes a locking member 42 carried by the second end 32 of the thirdstrap 30. An anchoring device 59 is carried by the sleeve 12 andarranged for engagement with the locking member 42. FIG. 4 particularlyshows the third strap 30 has a first end securing to the middle portion21 of the support 14 and a second end 32 forms part of a connectionassembly 20 for removably coupling the third strap 30 to the sleeve 12.The third strap 30 is preferably inelastic.

As shown in FIGS. 1-3A, the support 14 defines a preferred pattern ofopenings including at least one opening 28 formed along the length ofthe support 14 and extending from a periphery 61, 63 into a width of thesupport 14. The at least one opening 28 preferably extends past amidline or length adjustment axis 65 of the support from the periphery61, 63.

The at least one opening 28 may be formed as a slit and define first andsecond ends 62, 64. The first end 62 may extend past the midline 65short of a first periphery 61, 63 and the second end 64 is defined byopposed side portions 66, 67 clamped against one another depending onthe length of the support 14.

According to the variation in FIG. 3A, the main body 22 defines at leastone opening 28 formed along a first periphery 61 and at least oneopening 28 formed along a second periphery 63 of the support. The atleast one opening 28 is defined by a first set of openings 68 formedalong a first periphery 61 and a second set of openings 69 formed alonga second periphery 63. The first and second openings 68, 69 alternaterelative to one another along a length of the support 14.

The tensioning device 26 is preferably secured to the support 14 soactuation of the tensioning device 26 shortens or lengthens a length ofthe support 14. The a least one cable segment 24, 25 is linked to thetensioning device 26 and cooperates with the support 14 to adjust thelength thereof by actuation of the tensioning device 26. The at leastone cable segment 24, 25 extends through the thickness of the support 14and extends from the first end 17 to a second end 19 opposed to thefirst end 17 such that actuation of the tensioning device 26 adjusts thelength of the at least one cable segment 24, 25 to modify the length ofthe support 14. The support 14 defines at least one opening 28 throughwhich the at least one cable segment 24, 25 extends.

FIG. 3A illustrates the at least one cable as having first and secondcables 24, 25 linked to the tensioning device 26 and cooperating withthe support 14 to adjust the length thereof by actuation of thetensioning device 26. The first and second cables 24, 25 are on opposedsides of a midline 65 of the support 14.

Various cable types can be used, including but not limited to strandedsteel cable with no coating, stranded steel cable with a polymer coating(e.g., nylon coating), monofilament (e.g., nylon), or other suitableelongate elements. In some embodiments, standard conventional shoe lacesor textile cords can be used for the cable.

According to the illustrated embodiments, the tensioning device isconfigured to incrementally provide or release tension to the cable bytensioning. The tensioning device may correspond to a strap tightenerassembly for an orthopedic device according to U.S. application Ser. No.13/739,491, filed on Jan. 11, 2013 and published as U.S. patentapplication publication no. 2013/0184628 A1 on Jul. 18, 2013. Avariation of the tensioning device is also described in U.S. Pat. No.7,198,610, granted on Apr. 3, 2007, and U.S. Pat. No. 9,125,730, grantedSep. 8, 2015, which are incorporated herein by reference and belong tothe assignee of this disclosure. Commercial examples of a tensioningdevice that may also be used with different embodiments of the supportinclude the BOA lacing system of BOA Technology Inc. of SteamboatSprings, Colo.

The tensioning device is not limited to dial tensioning or a windingsystem but may include other ratcheting type systems such as a ladderratchet strap, as discussed in U.S. Pat. No. 7,198,610. Alternatively,the tensioning device can be simplified as a clasp arranged to disengagefrom the cables and lockingly engage upon a desired tension in the cableby applying traction or wedging. Examples of clasp or blocking devicesare described in U.S. Pat. No. 5,566,474, granted Oct. 22, 1996, U.S.Pat. No. 7,082,652, granted Aug. 1, 2006, U.S. Pat. No. 7,360,282,granted Apr. 22, 2008, each of which are incorporated by reference. Fromthe foregoing, a variety of tensioning devices may be employed incombination with the cable that enable locking of a desired tension inthe cable and the selective release of tension of the cable.

FIG. 5 exemplifies another embodiment of an end portion of a support 160having a similar arrangement to the support 14 in FIG. 3A. The support160 has a body 166 including first and second patterns of openings 168,169, along first and second peripheries 161, 162 of the support 160.Each of the openings includes a first end 162 extending past a midlineor length adjustment axis 165 extending generally along the midspan ofthe width of the support 160. A second end 164 is located along one ofthe peripheries 161, 162. A cable 170 may extend within across the firstand second patterns of openings 168,169 to a guide 171 located within oralong a surface of the body 166. The body 166 includes a head portion172 that may be secured directed to an article by suitable fasteners,such as hook-and-loop, buttons, or the like, or may include a strapattached thereto.

In observing FIG. 5, it is preferable that the openings of the first andsecond patterns overlap one another along the length adjustment axis165, such that the first ends 162 of the first and second patterns arelocated along opposed sides of the midline relative to the second ends164. This arrangement allows the support 160 to both accommodate shapeof a surface along which it is located and permits it to shorten orlengthen according to tension adjustment in the cable 170. Lengthadjustment will occur along the axis of length adjustment 165.

In an alternative, the support may be arranged so that openings do notoverlap. While in this alternative the support may not shorten orlengthen according to an increase in tension in the cable, the supportcan still adapt to a surface along which it is located. A variation ofsuch alternative may include different cables extending along across theopenings rather than a cable extending about the guide 171. The cableends may be anchored at the head portion 172 or other suitable location,and each cable may be adjusted differently so as to create differentshape profiles of the first and second peripheries 161, 162.

One of the features the support may have is the overlapping shapedescribed with FIGS. 1-5, so that as cables are adjusted, the supportmay conform to a surface along which it is located and apply tensionthereto. FIGS. 6A-6F depict alternative shape arrangements for theopening patterns, specifically shown as overlapping one another at leastto some extent to enable length adjustment of the support.

FIG. 6A shows a support 180 having a pattern of openings in theexemplary form of ellipses 181. At least some of the ellipses overlap181, particularly along a length adjustment axis 165. The ellipses 181may occur within peripheries of the support 180, or may be located openalong the peripheries as in ellipses 182. The openings may be in anordered configuration, and are not limited to being in the form ofellipses. The openings may have many shapes providing they enable bothshape and length adjustment of the support depending at least one partof adjustment of cables, as described in embodiments herein.

FIG. 6B depicts a support 183 which is a variation of the support 180 inFIG. 6A. The support 183 has random openings 184 in which at least someof the openings overlap one another along the length adjustment axis165. FIG. 6C shows a support 185 which is another variation of thesupport 180 in FIG. 6A. The support 185 represents a more narrow widththan the support 180, and minimizes the openings 186. A set of openings186 are generally aligned along the length adjustment axis 165, althoughopenings 187 are located along the peripheries to accommodate shape andlength adjustment of the support 185, and yet further openings may beprovided.

FIG. 6D depicts a support 188 having a pattern of opening in theexemplary form of a net-type shape whereby the openings are in apredetermined pattern with staggered openings 189 including partialopenings 190 along the peripheries of the support 188, but in which theopenings 189 overlap at least in part along the length adjustment axis165.

FIG. 6E shows a support 192 formed from a porous material havingopenings 193 inherent in the porous material enabling both length andshape adjustment along the length adjustment axis 165. These openingsmay be micro-holes in an open or closed cell foam such that themicro-holes allow the support to length upon stretching of the support,or collapse upon release of stretching of the support.

FIG. 6F depicts an example of a support 194 having sections 174, 175,176 with different dimensions. For example, the first section 174 has aheight H₁ and width W₃ greater than a second section 175 with a heightH₂ and width W₄. In this instance, the second section 175 may be atransitory section of the support providing greater bendability butarranged in an area requiring less support. The first section 174 maytransition to the second section 175 by a taper profile 177 to enablegradual diminution of support and increased bendability. The support 194may have a third section 176 having yet a different height H₃ and widthW₆ from the first and second sections 174, 175. Again, any of thesections may be arranged according to desired use of the support, andthe support 194 is merely exemplary to show how the support may bemodified according to prescribed needs of the support.

The support 194 may likewise have different patterns of openingsaccording to the sections, or may have yet further varying openingswithin a section itself. The first section 174 is shown with elongateopenings 195 generally uniformly spaced apart by height H₄, whereas thesecond section 175 has circular openings 196 spaced apart by height H₅which may be different from height H₄. Alternatively, the second section175 may be devoid of openings so that this region is substantiallynon-adjustable in height. The third section 176 has openings 197 ofdiffering lengths to cross the length adjustment axis 165, and may bespaced apart differently according to where they are located within thethird section 176. For example, some openings are spaced apart by heightH₆ whereas other openings are spaced apart by height H₇ which isdifferent from height H₆.

According to the embodiments described herein, a cable system and atensioning device may be adapted to different configurations. FIGS.7A-7C exemplify different configurations in which a single or multiplecables are employed and anchored or guided at different locations alongthe support. While the examples show the support generally having anarcuate or generally perpendicular configuration, the support is notlimited to such a shape and may take on the shape of elongate, circularor other shapes.

FIG. 7A shows first and second guides 40, 41 near the first end of thesupport 14 for redirecting the first and second cable segments 24, 25 ofat least one cable 27 to the tensioning device 26. A guide 60 is along aside of the tensioning device 26 and arranged to route the first andsecond cable segments 24, 25. According to this embodiment, the firstand second segments 24, 25 will adjust dependent of one another becauseof the cable 27. Because the cable 27 “doubles back” at the far ends orat the guides 40, 41 of the support, a doubling effect on the force isgenerated on the cable 27, similar to a pulley system.

FIG. 7B depicts another cable configuration 120 whereby the cable 121does not double back as in FIG. 7A. In this configuration, first andsecond cable segments 124, 126 are independently adjusted by thetensioning device 122 from one another such that the first and secondcable segments 124, 126 terminate at first and second anchors 128, 130.

FIG. 7C illustrates another cable configuration 140 in that the cable141 has first and second cable segments 144, 146 which couple to atensioning device 142, and terminate and secure to anchors 148, 150. Theanchors 148, 150 may be proximate to the tensioning device 142, and thefirst and second cable segments 144, 146 extend about guides 152, 154 sothe cable “doubles back.” In this configuration, while there is adoubling of the force generate when the cable 141 is tensioned, thefirst and second cable segments are generally independent of oneanother.

In any of the cable configurations, the tensioning device is not limitedto being centrally located along the cable configuration but may belocated so the initial lengths of the first and second cable segmentsare disproportionate relative to one another to achieve differentcontouring and tensioning of each of the first and second cablesegments. By placing the tensioning device generally in the middle ofthe cable configuration, the support may probably have a generallyuniform contraction. Alternatively, by disproportionately placing thetensioning device in the cable configuration, there may be non-uniformcontraction so the shape of the support may contort.

The cable configuration is not limited to a single tensioning device,however it is envisioned that multiple cables may be employed that arerespectively tensioned independently from one another by their own orshared tensioning devices. Additionally, while the cable configurationsschematically show the cable as generally linearly extending through orrelative to the body of the support, the cable may be arranged so thatit alternates between opposed sides of the length adjustment axis,either terminating at an anchor or returning toward or to the tensioningdevice much like lacing of shoes.

While the cable is described as extending through the body of thesupport in certain embodiments, it may be located along at least one ofthe surfaces of the body with external guides channeling the course ofthe cable. Alternatively, the support body may define channels withinthe thickness of the body through which the cable extends. Essentially,the cable configuration is arranged so that adjusting a length of thecable relative to the support enables length adjustment and/or shapecontouring of the support, whether the cable is internally or externallymounted relative to the support.

From these cable configurations and the aforementioned embodiments, amethod for adjusting a length involves adjusting tension in the at leastone cable or cable segments by regulating the tensioning device andcausing geometry of the at least one opening to modify according totension in the cable. Ends of the support are preferably anchored atfirst and second locations such that the length of the support adjustsalong the length adjustment axis according to regulation of thetensioning device. By providing at least one peripheral opening along aperiphery of the support, the shape of the support may be contouredaccording to regulation of the tensioning device by modifying a geometryof the peripheral opening as a result in adjustment of tension in the atleast one cable.

FIG. 8 illustrates another embodiment of a support 300 having a mainbody 302 generally forming a circular or oval profile, particularly anopening 329 for securing about a patella as in FIG. 1. For example, theinner profile 330 of the main body 302 is circular, and the outerprofile 328 is generally in a tear drop shape such that a first end 324is tapered whereas a second end 326 is rounded. The tear drop shapecaters to the first and second straps 312, 314 located at the first end324 to facilitate securing to the sleeve, as in FIG. 1. The roundedshape at the second end 326 is arranged to accommodate the tensioningdevice 304 and the third strap 306.

As with the embodiment of FIGS. 1-4, the third strap 306 includes ananchor 308 and a locking member 310 such as a pin or other connector tothe sleeve. One or multiple cables 316, 318 may be included in the mainbody 302 and coupled to the tensioning device 304.

The shape of the main body 302 may vary depending on the tension of thecables 316, 318 such that the opening 329 may be elongate, whereasreducing the tension will cause the opening 329 to reflect a morecircular profile. As with the embodiment of FIGS. 1 and 2, the at leastone opening in the form of slits 320, 322 may open or close toaccommodate the shape of the support depending on the displacement ofthe cables 316, 318. The first and second ends 324, 326 are preferablydevoid of the slits 320, 322 to reinforce the straps and serve as anchorportions of the main body 302 counteracting tension or securement of thestraps.

FIG. 9 shows an alternative embodiment of a support 80. The support 80includes an elongate body 82 defining a first end 81 including aconnection assembly 88 for securing to the sleeve 12. A second end isbifurcated into first and second portions 90, 92 each carrying a strap84, 86 arranged to secure to the sleeve 12 of FIGS. 1 and 2. Theelongate body 82 is preferably elastic and extends over the opening 23of the sleeve to secure the patella.

In this embodiment, a rear surface of the elongate body 82 may includesilicone to assist in maintaining the support 80 in position over theknee. The strap is particularly used to exert a downward force on thepatella and a lateral to medial pull. As with any of the embodiments,the connection assembly 88 may be secured to the elongate body 82 bystitching 44 extending through a plurality of apertures 46 formed by theconnection assembly 88.

FIG. 10 is another embodiment illustrating a support 400. The support400 includes first and second portions 402, 404 extending from a mainportion 403. The support 400 generally forms a U-shape subject todeformation according to actual use of the support. The first and secondportions 402, 404 include fastener tabs 406, 408 for securing to thesleeve 12. A connection assembly 411 secures to the main portion 403 andincludes a strap 410 and an anchor 412 with a locking member 414 forconnecting to the sleeve similarly to the embodiment of FIG. 1.

FIG. 11 shows the patella device 10 in use with an orthopedic device270. Although other orthopedic devices are envisioned, an example of asuitable orthopedic device may be found in U.S. Pat. No. 7,198,610.

FIGS. 12 and 13 illustrate an alternate embodiment of a patella device100. The patella device 100 includes a sleeve 102 arranged to secureover a user's leg similarly arranged as the embodiment of FIG. 1. Thesupport 114 is covered by a covering 115 adapted to accommodate movementof the support as it expands or contracts due to tensioning of cablestherein, as in the embodiment of FIG. 1. FIG. 13 shows how a hinge 121and corresponding struts 119 may be located within or concealed by thesleeve 112 by a covering 118.

FIGS. 14-16 depict another alternate embodiment of a patella device 210for use with an unloading brace 270 with a strap assembly having dynamicforce straps 272, 274. The patella device 210 includes a main body 212defining a central portion 214 and first and second side portions 216,217. The first side portion 216 includes bifurcated first and secondextensions 218, 219. A support 215 secures to the first side 216 andextends along the first and second extensions 218, 219.

The first and second extensions 218, 219 include connection elements 220for securing to the orthopedic device 270 at frame supports 276, 278spaced apart by struts 280, 282. The second side portion 217 includesbifurcated first and second extensions 221, 222. The first and secondextensions 221, 222 of the second side 217 include connection elements223, and may extend over or underneath the strap assembly 272, 274supported by the unloading device 270.

Referring to FIGS. 17 to 19, an ankle brace 500 is arranged with anankle support 502 attached to an ankle brace 510 adapted for adjustingan angle of a user's ankle for inversion and eversion control of anankle. The brace 500 includes a foot plate or foot portion 512 and anupper portion 510 connectable above a user's ankle. The support 502 islocated between or at the upper portion 510 and the foot plate 512. Thesupport 502 has openings 506 and is adjustable by a tensioning device504 secured to a cable 508 in a manner according to any of theaforementioned configurations. A distance 514 of the support 502 betweenthe upper portion 510 and the foot plate 512 is adjustable in length andangle according to adjustment of the tensioning device.

The support may be constructed of a material that is substantially rigidor becomes sufficiently rigid to place and maintain an ankle in adesired eversion or inversion configuration according adjustment by thetensioning device. The support may be sufficiently compressible toenable comfort to the user's ankle as the support is adjusted. The shapeor geometry of the support may be adapted for contouring to a user'sankle such in the illustrated example whereby the width of the supporttapers from the foot plate to the upper portion.

The embodiments of the support described above in accordance with thepresent disclosure reduce pain, speed healing processes, and impartimproved stability and mobility in numerous indications. In anorthopedic device, for example, the support permits more preciseadjustment and enables efficient coordination between a medicalprofessional and the wearer on the degree the orthopedic device shouldbe configured. Patient comfort is also enhanced and donning and doffingof the orthopedic device is eased with the novel features described.

It is to be understood that not necessarily all such objects oradvantages may be achieved under any embodiment of the disclosure. Thoseskilled in the art will recognize that the support, either by itself orcombined with another article such as an orthopedic device, may beembodied or carried out in a manner that achieves or optimizes oneadvantage or group of advantages as taught without achieving otherobjects or advantages as taught or suggested.

The skilled artisan will recognize the interchangeability of variousfeatures from different embodiments. Besides the variations described,other known equivalents for each feature can be mixed and matched by oneof ordinary skill in this art to construct a support or an orthopedicdevice under principles of the present disclosure.

Although the support has been disclosed in certain preferred embodimentsand examples, it therefore will be understood by those skilled in theart that the present invention extends beyond the specifically disclosedembodiments to other alternative embodiments and/or uses of the supportand obvious modifications and equivalents thereof. It is intended thatthe present disclosure should not be limited by the particular disclosedembodiments described above.

The invention claimed is:
 1. A support, comprising: a body having afirst portion, a second portion and a middle portion separating thefirst and second portions, the body defining a length adjustment axis; atensioning device connected to the support wherein adjustment of thetensioning device shortens or lengthens a length of the support at leastthrough the middle portion along the length adjustment axis; a firststrap extending from a first end at the first portion of the body andgenerally parallel therewith; and a second strap extending from a secondend at the second portion of the body and generally parallel therewith;a third strap having a first end secured to the middle portion of thebody and extending outwardly therefrom generally laterally therefrom. 2.The support of claim 1, wherein the third strap carries a locking memberextending from a second end of the third strap.
 3. The support of claim1, wherein the third strap extends from the body whereat the tensioningdevice is located.
 4. The support of claim 1, wherein the third strap isinelastic.
 5. The support of claim 1, further comprising at least onecable linked to the tensioning device and extending through a thicknessof the body from the first portion to the second portion of the bodysuch that actuation of the tensioning device adjusts a length of thebody.
 6. The support of claim 5, wherein the thickness of the bodyconsists between top and bottom surfaces of the body, the body forming achannel within the thickness of the body and being located at a centerportion of the body through which the at least one cable extends.
 7. Thesupport of claim 5, wherein the body defines at least one openingoverlapping at least part of the length adjustment axis such that lengthadjustment is governed by modification of a size of the at least oneopening according to adjustment by the tensioning device.
 8. The supportof claim 5, wherein the body defines at least one opening formed alongthe length of the support and extending from a periphery into a width ofthe support, a channel being defined on opposed sides of the at leastone opening and the at least one cable extending between and within theat least one opening.
 9. The support of claim 8, wherein the at leastone opening extends past the length adjustment axis of the support fromthe periphery, the length adjustment axis being defined along a midlineof the body.
 10. The support of claim 8, wherein the at least oneopening defines first and second ends, the first end extending past thelength adjustment axis short of a first periphery and the second enddefined by opposed side portions arranged to clamp against one anotherdepending on the length of the support, the length adjustment axis beingdefined along a midline of the body.
 11. The support of claim 1, whereinthe body forms a C-shape generally bending through the middle portion.12. The support of claim 1, wherein a thickness of the body varies alongthe length adjustment axis.
 13. The support of claim 1, wherein across-section of a thickness of the body has a first thickness at acenter portion, and a second thickness edge portions that is less thanthe first thickness.
 14. The support of claim 1, wherein body has arounded top surface varying in height from first to second edge portionswhen the body is viewed in cross section.
 15. An orthopedic device,comprising: a sleeve; a support having first and second ends removablysecured to the sleeve, the support including: a body having a firstportion, a second portion and a middle portion separating the first andsecond portions, the body defining a length adjustment axis; atensioning device connected to the support wherein adjustment of thetensioning device shortens or lengthens a length of the support at leastthrough the middle portion along the length adjustment axis; at leastone cable linked to the tensioning device and extending through athickness of the body from the first portion to the second portion ofthe body such that actuation of the tensioning device adjusts a lengthof the at least one cable, a thickness of the body including between topand bottom surfaces of the body, the body forming a channel within thethickness of the body and being located at a center portion of the bodythrough which the at least one cable extends.
 16. The orthopedic deviceof claim 15, wherein the sleeve includes a stay located on at least oneof lateral and medial sides, the support having a third strap extendingfrom the body and securing to the sleeve proximate the stay.
 17. Theorthopedic device of claim 16, wherein the third strap carries ananchoring device removably securable to a connection assembly of thesleeve proximate the stay.
 18. The orthopedic device of claim 17,wherein the third strap extends from the middle portion of the body andlaterally relative to the body whereat the third strap extends.
 19. Asupport, comprising: a body having a first portion, a second portion anda middle portion separating the first and second portions, the bodydefining a length adjustment axis; a tensioning device connected to thesupport wherein adjustment of the tensioning device shortens orlengthens a length of the support at least through the middle portionalong the length adjustment axis; at least one cable linked to thetensioning device and extending through a thickness of the body from thefirst portion to the second portion of the body such that actuation ofthe tensioning device adjusts a length of the at least one cable, athickness of the body consisting between top and bottom surfaces of thebody, the body forming a channel within the thickness of the bodythrough which the at least one cable extends; wherein the body definesat least one opening overlapping at least part of the length adjustmentaxis such that length adjustment is governed by modification of a sizeof the at least one opening according to adjustment by the tensioningdevice, the channel defined on opposed sides of the at least one openingand the at least one cable extending through the at least one opening.